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Perceptions of the osteopathic profession in New York City's Chinese Communities.

ABSTRACT: Objective:The purpose of this study was to assess knowledge of and barriers to osteopathic medicine in Chinese immigrant communities in New York City (NYC). Design:A cross-sectional study was designed in which a culturally appropriate survey in Chinese and English versions was administered anonymously to measure immigrant perceptions and knowledge of osteopathic medicine. Setting:Data collection occurred in the municipal delineations for the Chinatown neighbourhood within the New York, New York borough of Manhattan. Participants:Community members were selected using convenience sampling from high-density areas to participate. Information gathered from the survey included demographics, education level, healthcare habits and knowledge of the osteopathic profession. Results:120 surveys were conducted with 68 males and 52 females, with an average age=40. Respondents in the age range of 18-29 years, those with fluent English-language proficiency, and participants with graduate-level education status demonstrated a higher proportion of knowledge of osteopathic manipulative medicine and osteopathic physicians (doctors of osteopathic medicine) among the study variables. Conclusion:Compared with research on the general US population, a general lack of knowledge of osteopathic medicine exists within NYC's Chinese immigrant community. Although this difference may be ascribed to linguistics and ethnosociological factors, greater outreach and education is needed in urban minority communities to make immigrants aware of all healthcare resources available during the current shortage of US primary care physicians.

SUBMITTER: Chin J

PROVIDER: S-EPMC7069261 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Perceptions of the osteopathic profession in New York City's Chinese Communities.

Chin Justin J Li Sarah S Yim Gregory G Zhou YaQun Arlene YA Wan Peter Justin PJ Dube Emily R ER Volokitin Mikhail M Sahni Sonu S Terrell Mark A MA Lomiguen Christine M CM

Family medicine and community health 20200228 1

<h4>Objective</h4>The purpose of this study was to assess knowledge of and barriers to osteopathic medicine in Chinese immigrant communities in New York City (NYC).<h4>Design</h4>A cross-sectional study was designed in which a culturally appropriate survey in Chinese and English versions was administered anonymously to measure immigrant perceptions and knowledge of osteopathic medicine.<h4>Setting</h4>Data collection occurred in the municipal delineations for the Chinatown neighbourhood within t ...[more]

PMID: 32201549

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Project description:ImportanceThe spring 2020 surge of COVID-19 unprecedentedly strained ventilator supply in New York City, with many hospitals nearly exhausting available ventilators and subsequently seriously considering enacting crisis standards of care and implementing New York State Ventilator Allocation Guidelines (NYVAG). However, there is little evidence as to how NYVAG would perform if implemented.ObjectivesTo evaluate the performance and potential improvement of NYVAG during a surge of patients with respect to the length of rationing, overall mortality, and worsening health disparities.Design, setting, and participantsThis cohort study included intubated patients in a single health system in New York City from March through July 2020. A total of 20 000 simulations were conducted of ventilator triage (10 000 following NYVAG and 10 000 following a proposed improved NYVAG) during a crisis period, defined as the point at which the prepandemic ventilator supply was 95% utilized.ExposuresThe NYVAG protocol for triage ventilators.Main outcomes and measuresComparison of observed survival rates with simulations of scenarios requiring NYVAG ventilator rationing.ResultsThe total cohort included 1671 patients; of these, 674 intubated patients (mean [SD] age, 63.7 [13.8] years; 465 male [69.9%]) were included in the crisis period, with 571 (84.7%) testing positive for COVID-19. Simulated ventilator rationing occurred for 163.9 patients over 15.0 days, 44.4% (95% CI, 38.3%-50.0%) of whom would have survived if provided a ventilator while only 34.8% (95% CI, 28.5%-40.0%) of those newly intubated patients receiving a reallocated ventilator survived. While triage categorization at the time of intubation exhibited partial prognostic differentiation, 94.8% of all ventilator rationing occurred after a time trial. Within this subset, 43.1% were intubated for 7 or more days with a favorable SOFA score that had not improved. An estimated 60.6% of these patients would have survived if sustained on a ventilator. Revising triage subcategorization, proposed improved NYVAG, would have improved this alarming ventilator allocation inefficiency (25.3% [95% CI, 22.1%-28.4%] of those selected for ventilator rationing would have survived if provided a ventilator). NYVAG ventilator rationing did not exacerbate existing health disparities.Conclusions and relevanceIn this cohort study of intubated patients experiencing simulated ventilator rationing during the apex of the New York City COVID-19 2020 surge, NYVAG diverted ventilators from patients with a higher chance of survival to those with a lower chance of survival. Future efforts should be focused on triage subcategorization, which improved this triage inefficiency, and ventilator rationing after a time trial, when most ventilator rationing occurred.

Dataset Information

Perceptions of the osteopathic profession in New York City's Chinese Communities.

Publications

Perceptions of the osteopathic profession in New York City's Chinese Communities.

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